Successful treatment of complex aphthosis with colchicine and dapsone.

OBJECTIVE: To investigate the effectiveness of colchicine and dapsone, 2 corticosteroid-sparing anti-inflammatory agents, in the treatment of patients with complex aphthosis (recurrent oral and genital aphthous ulcers or severe, almost constant, multiple oral aphthae in the absence of Behçet syndrome).

DESIGN: Retrospective review of medical records.

SETTING: Tertiary care medical clinic.

PATIENTS: Fifty-five patients with complex aphthosis evaluated and treated at Mayo Clinic between January 1, 1998, and July 31, 2007. All the patients were treated according to a therapeutic ladder, starting with colchicine and adding dapsone to treatment of patients who did not have a substantial response (>75% improvement) to colchicine or who discontinued colchicine use because of adverse effects.

MAIN OUTCOME MEASURES: A substantial response to therapy with colchicine alone, dapsone alone, or colchicine and dapsone combined.

RESULTS: Most patients (44 [80%]) had a substantial response to therapy and had no serious adverse effects.

CONCLUSIONS: Colchicine and dapsone are effective, safe therapies for the treatment of complex aphthosis. Colchicine and dapsone, 2 established drugs also used for gout and leprosy, respectively, and for other dermatologic disorders, should be considered efficacious in the treatment of complex aphthosis.